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Cataract Surgery Lens Dislocation Probability

8-year incidence rate for Intraocular Lens  Dislocation MEN: 1.03% , WOMEN 0.58%

Phacoemulsification

 also known as phaco, is a modern cataract surgery technique that uses ultrasonic energy to break up and remove a cataractous lens from the eye:

• The surgeon makes a small incision in the cornea

• A small ultrasonic probe is inserted through the incision and used to break the lens into small pieces

• The fragments are then suctioned out of the eye

• A permanent artificial lens, called an intraocular lens (IOL), is placed in the capsular bag that previously held the cataractous lens

Pseudophakia: Intraocular Lenses and What They Treat

means “fake lens.” It's a term that's used after you've had an artificial lens implanted in your eye to replace your own ...

We investigate the incidence and characteristics of IOL dislocation among the pseudophakic population after phacoemulsification.

Methods:

National data were collected from the health claims recorded with the Health Insurance Review and Assessment Service of South Korea from 2009 to 2016.

Pseudophakic patients aged 40 years or older were included.

The incidence estimates of phacoemulsification and IOL dislocation were analyzed, and the cumulative probabilities of IOL dislocation among the pseudophakic population and general population were calculated as a proportion.

Results: Of 51,307,821 total subjects, 25,271,917 of whom were aged 40 years or older,

3,906,071 cataract cases in 2,650,104 pseudophakic patients were identified, and

72,309 patients experienced IOL dislocation.

The cumulative probability was 2.73% per person and 1.85% per surgery among patients 40 years of age or older.

The 8-year incidence rate for IOL dislocation in the pseudophakic population aged 40 years or older was

7671 per 1,000,000 person-years (95% CI: 7616–7727),

including 10,341 cases in men and 5814 in women.

THATS MEN: 1.03% , WOMEN 0.58%

Incidence peaked in the 7th decade of life for cataract surgery but in the 5th decade of life for IOL dislocation.

The cumulative probability of IOL dislocation after phacoemulsification was approximately 2%, and ??????????????????

the incidence rate was about 7000 per 1,000,000 pseudophakic patients. ??????????????????????????????????

Conclusions:

There was a significantly higher incidence of IOL dislocation among young males, even though the higher incidence of cataract surgery was observed among older females.

These estimates of the nationwide, population-based incidence of IOL dislocation can help increase understanding of the population vulnerable to IOL dislocation.

SOURCE: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432084/

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COPILOT AI

The incidence of posterior chamber intraocular lens (IOL) dislocation after cataract surgery:

Early Dislocation (Within the First Week):

Approximately 0.3% of patients require subsequent IOL exchange due to early dislocation1.

Most cases occur shortly after cataract surgery, often within the first week.

Causes include inadequate support for the IOL due to zonular or capsular damage.

Late Dislocation (3 Months or More After Surgery):

The cumulative risk of late IOL dislocation increases over time:

• 0.1% at 5 years

• 0.1% at 10 years CONTRADICTS THE ABOVE 1.03%

• 0.2% at 15 years

• 0.7% at 20 years

• 1.7% at 25 years . https://link.springer.com/chapter/10.1007/978-3-031-05394-8_86

Late dislocations may result from

• --- trauma,

• --- silicone plate IOLs passing through capsular defects, or

• --- progressive zonular dehiscence.

Risk Factors:

Men are more likely to be affected than women, although the reason remains unclear3.

Other risk factors include https://www.asrs.org/patients/retinal-diseases/27/intraocular-lens-dislocation

• --- prior vitreoretinal surgery,

• --- pseudoexfoliation syndrome,

• --- certain connective tissue disorders, and

• --- inflammation in the eye (uveitis).

Remember that individual cases can vary, and regular follow-up with an ophthalmologist is crucial for monitoring IOL stability.

Silicone Plate IOLs Passing Through Capsular Defects:

·       Some IOLs have a silicone plate design.

·       If there’s a defect (a hole or weakness) in the capsule (the thin membrane that holds the lens), the IOL can move or shift.

·       Imagine it like a contact lens slipping out of place due to a tear in its container.

Progressive Zonular Dehiscence:

·       The zonules are delicate fibers that hold the natural lens in place within the eye.

·       Dehiscence means weakening or breaking of these fibers.

·       When the zonules weaken progressively, the lens may become unstable or dislocated.

·       Think of it as the “suspension cables” of the lens losing strength.

Pseudoexfoliation Syndrome:

·       This is a condition where tiny, flaky deposits accumulate on the lens capsule and other eye structures.

·       These deposits are pseudoexfoliative material and can affect the lens stability.

·       It’s like having dust settle on a camera lens, causing visual disturbances.

Certain Connective Tissue Disorders:

·       Some disorders (like Marfan syndrome or Ehlers-Danlos syndrome) affect the strength and elasticity of connective tissues.

·       In the eye, weakened connective tissues can impact lens stability.

·       Picture it as the “framework” of the eye becoming less sturdy.